Via practica 2/2017

Epilepsy versus syncope – case report

Despite the fact, that the significant progress in the diagnosis and treatment of syncope has made in recent years, the care of the patient with syncope is not satisfactory (1). We can suppose, the reason of the unsatisfactory care is insufficient application of knowledges into practice. The European Society of Cardiology publishes standards for the diagnosis and treatment of syncope. In emergency services practice are applicable recommendations of 2015. According to these recommendations each transient loss of consciousness requires an initial assessment of the patient’s condition already in the prehospital phase (2). A diagnostic algorithm includes a thorough history of the progress of transient loss of consciousness, physical examination, including measurement of pressure sitting position and standing position, orientation neurological examination to rule out stroke or transient ischemic attack, and 12-lead ECG. The last one is not realized in exits emergency medical services in every patient with collapse. The present situation is, that the ECG implementation is affected not only by knowledges about the pathophysiological mechanisms of syncope, but to some extent also by instinct of investigating physician. Article provides comprehensive knowledge on the progress of the primary care physician in the collapse, differences between epilepsy and cardiac syncope. The case report highlights the fact that not all that impresses like epilepsy, is epilepsy. Electrocardiogram and correct interpretation of symptoms revealed for varicose unconsciousness serious cardiac syncope.

Keywords: lectrocardiogram, transient loss of consciousness, cardiac syncope